JENNIFER ANN TERASA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

ANN

Last Name

TERASA

Business Name

JENNIFER ANN TERASA

Original Issue Date

09/15/2008

Effective Date

02/02/2016

Expiration Date

03/01/2018

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

05/02/2018